New York Times puts pharmacy benefit managers on the front page
Reporters have accused PBMs of steering patients toward more expensive drugs and extracting hidden fees.
The New York Times has heightened already intense policymaker scrutiny of pharmacy benefit managers by putting a long, critical article about their work on the front page of the issue that ran Friday.
Rebecca Robbins and Reed Abelson wrote a PBM article with the kicker “The Middlemen” and the headline “The Opaque Industry Secretly Inflating Prices for Prescription Drugs.”
Related: Warning signs: Are you working with a self-serving PBM?
PBMs formed to help health insurers and self-funded health plans save money on prescription drugs.
Instead, the Times reporters write, PBMs “steer patients toward pricier drugs, charge steep markups on what would otherwise be inexpensive medicines and extra billions of dollars in hidden fees.”
Many brokers, consultants and public officials have been critical of PBMs in recent years.
Attorney generals in 39 states have asked Congress to pass bills that would toughen the rules for PBMs that serve self-insured health plans.
But JC Scott, the president of the Pharmaceutical Care Management Association, a trade group for PBMs, said in a statement that the article “was slanted, biased and incomplete.”
“The myth that PBMs inflate drug prices originated with the pharmaceutical industry,” Scott said. “Without the ability to negotiate for lower prescription drug costs, Americans would be paying significantly higher drug prices.”
Shortly before the Times article came out, one of the biggest PBMs, Cigna’s Express Scripts business, released an analysis showing that its members paid an average of just $15.10 out-of-pocket for a 30-day prescription in 2023, down 1% from the 202 average.
The average out-of-pocket cost fell even as the annual list price for a new U.S. drug increased to about $300,000, from $222,000 in 2022, the company said.
“Express Scripts holds drug manufacturers accountable for their prices and uses generic and biosimilar competition to help ensure patients who need these medications can afford them at the pharmacy counter,” according to Adam Kautzner, Express Scripts’ president.